Viscusi Design- Freelance Web & Print Design

Providing the following information will help me better understand the type of website or service you require. Please be as detailed as possible. Be sure to include examples of sites you find compelling or site features and link names you know you would like to include.

First Name:

Last Name:

Company:

E-mail:

Phone:

Do you currently have an existing website?

Yes

If yes, what is the URL of the Website?

What is the nature of your business?

I am interested in:

Please select a timeframe:

Proposed names for your webpages:

(ex. About Us, Team, Contact, etc.)

I also will need:

	A Domain Name		Marketing Materials
	Hosting Package		Photo or Portfolio Gallery
	Logo		Ability to Accept Payments
	Banner Ad		Custom Craigslist Ad

* If you need a gallery please indicate estimated size:

ex. number of images, categories, or products.

What will you provide me with?

	A Site Map		Images/Graphics
	Content		Nothing I Need Help
	Photos		Other

What type of look are you trying to achieve?
(check all that apply):

	Corporate		Children
	Conservative		Family
	Radical/Bold		Hi-Tech
	Masculine		Academic
	Feminine		Night Club/Promotional
	Fun		Cultural
	Nature Oriented		Religious/Spiritual
	Sports		Clean lines/Less is More

Any examples of work you like?:

Example 1:	Example 2:

How did you hear about me?

	Craigslist		Postcard/Mailer
	Search Engine		Client Referral
	Friend		Other

Additional Comments or Specific Needs:
(please be as detailed as possible)